HomeMy WebLinkAboutBuilding permit appPermit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
Commercial
PERMIT APPLICATION FOR: pedestal replacement
PROPOSED IMPROVEMENT LOCATION:
Address: 10701 S. Ocean Dr., Lot 872, Jensen Beach, FL 34957
Property Tax ID #: 4511-510-0073-000-9
Site Plan Name:
Project Name: Kolakowski
DETAILED DESCRIPTION OF WORK:
Remove existing anlbd replace 150 amp pedestal
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential X
Lot No. 872
Block No.
Additional work to be performed under this permit —check all that. apply:
Mechanical _ Gas Tank —Gas Piping _ Shutters Windows/Doors Pond
.N Electric _ Plumbing Sprinklers _ Generator — Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2,000.00 Utilities: Sewer
OWNERAESSEE: CON
Name Craig Kolakowski
NamE
Address:10701 S. Ocean Dr. Lot 872
Comb
City: Jensen Beach State:
AddrE
Zip Code: 34957 Fax:
City: I
Phone No.
Zip Cc
E-Mail:
PhonE
Fill in fee simple Title Holder on next page { if different
E-Mai
from the Owner listed above)
State
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
-6C
I D
Septic Building Height:
TRACTOR:
-Michael Dale Ault
any:Ault Bros, Inc. Electrical Contractor
ss: PO Box 1528
'ort Salerno State: FL
de: 34992 Fax:
No 772-283-5520
aultbros@yahoo.com
)r County License ECO001693
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
DATE
RECEIVED
DATE
COMPLETED
SUPPLEMENTAL CONSTRICTION LIEN LAW INFORM ATION:
DESIGNER/ENGINEER-
Name:—
Address:
City:
Zip:
Phone
Not Applicable MORTGAGE COMPANY: Not Applicable
Name:
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:_
Address:
City:
Zip:
Pho
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Horde Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney beforecommencing work or recording our Notic of Comrp-encement.
of Owner/ L'esee%Contractor a agent fo Owner
STATE OF FLORIDA
COUNTY OF Martin
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this day of 2020 by
Michael pale Aull
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced
Signature of Contractor/License Hol
STATE OF FLORIDA
COUNTY OF Martin
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this 10-IS'" day of 40, 2 b3 �-i - 2020 by
Michael Dale Auit
Name of person making statement.
Personally Known x OR Produced Identification
Type of identification
Produced
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